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Lean six sigma

Renée J Roberts, Ashley E Wilson, Zenaide Quezado
Six Sigma and Lean methodologies are effective quality improvement tools in many health care settings. We applied the DMAIC methodology (define, measure, analyze, improve, control) to address deficiencies in our pediatric anesthesia supply chain. We defined supply chain problems by mapping existing processes and soliciting comments from those involved. We used daily distance walked by anesthesia technicians and number of callouts for missing supplies as measurements that we analyzed before and after implementing improvements (anesthesia cart redesign)...
October 3, 2016: Anesthesia and Analgesia
Melissa S D'Andrea, P Marco Fisichella
BACKGROUND: Postoperative pain remains undertreated in critically ill patients. We hypothesized that the adequacy of pain control in our Surgical Intensive Care Unit (SICU) was above the reported average of 71 % in the literature and that the introduction of the critical care pain observation tool (CPOT) could improve it. We used a Lean Six Sigma methodology to improve our processes and quantify our improvement. PATIENTS AND METHODS: We retrospectively review 713 consecutive veterans admitted to our SICU...
October 4, 2016: World Journal of Surgery
Sandra G Leggat, Richard Gough, Timothy Bartram, Pauline Stanton, Greg J Bamber, Ruth Ballardie, Amrik Sohal
Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010...
September 19, 2016: Journal of Health Organization and Management
Mark Lerner
No abstract text is available yet for this article.
May 2016: Radiology Management
Stephen J Gleich, Michael E Nemergut, Anthony A Stans, Dawit T Haile, Scott A Feigal, Angela L Heinrich, Christopher L Bosley, Sandeep Tripathi
BACKGROUND AND OBJECTIVES: Ineffective and inefficient patient transfer processes can increase the chance of medical errors. Improvements in such processes are high-priority local institutional and national patient safety goals. At our institution, nonintubated postoperative pediatric patients are first admitted to the postanesthesia care unit before transfer to the PICU. This quality improvement project was designed to improve the patient transfer process from the operating room (OR) to the PICU...
August 2016: Hospital Pediatrics
Lamia Almorsy, Mohamed Khalifa
Healthcare costs have been increasing worldwide mainly due to over utilization of resources. The savings potentially achievable from systematic, comprehensive, and cooperative reduction in waste are far higher than from more direct and blunter cuts in care and coverage. At King Faisal Specialist Hospital and Research Center inappropriate and over utilization of the glucose test strips used for whole blood glucose determination using glucometers was observed. The hospital implemented a project to improve its utilization...
2016: Studies in Health Technology and Informatics
Chrysanthy Ha, Donald A McCoy, Christopher B Taylor, Kayla D Kirk, Robert S Fry, Jitendrakumar R Modi
Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station...
June 2016: Military Medicine
Nancy Leighton Robinson
Effective perioperative hand-off communication is essential for patient safety. The purpose of this quality improvement project was to demonstrate how a structured hand-off tool and standardized process could increase effective perioperative communication of essential elements of care and assist in the timely recognition of patients at risk for clinical deterioration in the initial postoperative period. A team-based pilot project used the Iowa Model of Evidence-Based Practice and the principles of Lean Six Sigma to implement Perioperative PEARLS, a perioperative specific hand-off communication tool and a standardized framework for hand-off communication...
June 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Thelina Amaratunga, Julian Dobranowski
PURPOSE: Preventable yet clinically significant rates of medical error remain systemic, while health care spending is at a historic high. Industry-based quality improvement (QI) methodologies show potential for utility in health care and radiology because they use an empirical approach to reduce variability and improve workflow. The aim of this review was to systematically assess the literature with regard to the use and efficacy of Lean and Six Sigma (the most popular of the industrial QI methodologies) within radiology...
September 2016: Journal of the American College of Radiology: JACR
Charles Scott Hultman, Sendia Kim, Clara N Lee, Cindy Wu, Becky Dodge, Chloe Elizabeth Hultman, S Tanner Roach, Eric G Halvorson
PURPOSE: Perforator flaps have become a preferred method of breast reconstruction but can consume considerable resources. We examined the impact of a Six Sigma program on microsurgical breast reconstruction at an academic medical center. METHODS: Using methods developed by Motorola and General Electric, we applied critical pathway planning, workflow analysis, lean manufacturing, continuous quality improvement, and defect reduction to microsurgical breast reconstruction...
June 2016: Annals of Plastic Surgery
Yvonne Y Cheung, Eric M Goodman, Tomiwa O Osunkoya
Long wait times limit our ability to provide the right care at the right time and are commonly products of inefficient workflow. In 2013, the demand for musculoskeletal (MSK) procedures increased beyond our department's ability to provide efficient and timely service. We initiated a quality improvement (QI) project to increase efficiency and decrease patient time of stay. Our project team included three MSK radiologists, one senior resident, one technologist, one administrative assistant/scheduler, and the lead technologist...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Ara Ko, Jason S Murry, David M Hoang, Megan Y Harada, Lia Aquino, Charles Coffey, Harry C Sax, Rodrigo F Alban
BACKGROUND: Changes in health care policies have influenced transformations in hospital systems to be cost-efficient while maintaining robust outcomes. This is particularly important in intensive care units where significant resources are used to care for critically ill patients. We sought to determine whether high-value care processes (HVCp) implemented in a surgical intensive care unit (SICU) have an impact on commonly used ancillary tests. MATERIALS AND METHODS: An implementation phase using a Lean Six Sigma approach was performed in October 2014 at a 24-bed large academic center SICU with aims to decrease orders of excessive daily laboratory tests and X-rays...
May 15, 2016: Journal of Surgical Research
Danielle B Cameron, Shawn J Rangel
PURPOSE OF REVIEW: The goal of this review is to provide updates on the evolution of conceptual definitions as they relate to quality in healthcare, existing measurement platforms for performance benchmarking in pediatric surgery, and available tools for quality improvement that are relevant to care of the pediatric surgical patient. RECENT FINDINGS: The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric has continued to evolve, now providing risk-adjusted safety outcomes data to over 70 hospitals and broadening its scope of quality measurement to include resource utilization and value-based metrics...
June 2016: Current Opinion in Pediatrics
Tracie Wilt Major, Tricia K Huey
Intravenous infiltrates pose tremendous risk for the hospitalized pediatric patient. Infiltrate events increase hospital-acquired harm, the number of painful procedures, use of supplies, length of stay, and nursing time; it threatens relationships essential in patient- and family-centered care. The goal of this quality improvement project was to achieve a 10% decrease in the baseline infiltrate rate on two inpatient units and in the overall infiltrate rate across all of the pediatric units. A Lean Six Sigma methodology was used to guide project activities...
January 2016: Pediatric Nursing
Samuel A Silver, Ziv Harel, Rory McQuillan, Adam V Weizman, Alison Thomas, Glenn M Chertow, Gihad Nesrallah, Chaim M Bell, Christopher T Chan
Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Simon Deblois, Luigi Lepanto
PURPOSE: The purpose of this paper is to present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. To identify areas of future research. DESIGN/METHODOLOGY/APPROACH: A literature search was conducted, using eight databases...
2016: International Journal of Health Care Quality Assurance
Shikhar Agarwal, Justin J Gallo, Akhil Parashar, Kanika K Agarwal, Stephen G Ellis, Umesh N Khot, Robin Spooner, Emin Murat Tuzcu, Samir R Kapadia
BACKGROUND: Operational inefficiencies are ubiquitous in several healthcare processes. To improve the operational efficiency of our catheterization laboratory (Cath Lab), we implemented a lean six sigma process improvement initiative, starting in June 2010. We aimed to study the impact of lean six sigma implementation on improving the efficiency and the patient throughput in our Cath Lab. METHODS: All elective and urgent cardiac catheterization procedures including diagnostic coronary angiography, percutaneous coronary interventions, structural interventions and peripheral interventions performed between June 2009 and December 2012 were included in the study...
March 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Patrícia de Oliveira Furukawa, Isabel Cristina Kowal Olm Cunha, Mavilde da Luz Gonçalves Pedreira
OBJECTIVE: to analyze sustainable actions from an environmental point of view in the medication process, from the reception of the prescription of the pharmacy to waste discard by nursing. METHOD: study before and after performed through Lean Six Sigma methodology. The sample consisted of the amount and type of waste resulting from the pharmacy and nursing services of a medical-surgical clinical unit. RESULTS: after the intervention was obtained at the pharmacy a reduction of 74...
January 2016: Revista Brasileira de Enfermagem
Yara L Basta, Inez M Zwetsloot, Jean H G Klinkenbijl, Thomas Rohof, Mathijs M C Monster, Paul Fockens, Kristien M A J Tytgat
RATIONALE, AIMS AND OBJECTIVES: Timely communication is important to ensure high-quality health care. To facilitate this, the Gastro Intestinal Oncology Center Amsterdam (GIOCA) stipulated to dispatch medical reports on the day of the patient's visit. However, with the increasing number of patients, administrative processes at GIOCA were under pressure, and this standard was not met for the majority of patients. The aim and objective of this study was to dispatch 90% of medical reports on the day of the patient's visit by improving the logistic process...
October 2016: Journal of Evaluation in Clinical Practice
A Tekes, E M Jackson, J Ogborn, S Liang, M Bledsoe, D J Durand, G Jallo, T A G M Huisman
BACKGROUND AND PURPOSE: Lean Six Sigma methodology is increasingly used to drive improvement in patient safety, quality of care, and cost-effectiveness throughout the US health care delivery system. To demonstrate our value as specialists, radiologists can combine lean methodologies along with imaging expertise to optimize imaging elements-of-care pathways. In this article, we describe a Lean Six Sigma project with the goal of reducing the relative use of pediatric head CTs in our population of patients with hydrocephalus by 50% within 6 months...
June 2016: AJNR. American Journal of Neuroradiology
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